Vaccination pain management for adults: Guidance for health care providers

On this page

• Overview
• Examples for a comfortable vaccination
  • Muscle tension technique
  • Needle fear
• Additional resources

Overview

Vaccination is important at every stage of life; however, for some people, these procedures can cause unnecessary pain and stress, which can make them less likely to adhere to suggested vaccine schedules and miss essential immunizations. Health care providers play an important role in a person’s decision to be vaccinated and their comfort during this process.

For optimal protection, it is important to review a patient’s vaccination record at every opportunity and offer any needed vaccines. Adults may need a booster dose or to catch up on previously missed dose of vaccine.

As a health care provider, you have an opportunity to help make a patient’s vaccination experience comfortable and help reduce pain during vaccine injections. Building trust with your patients increases the likelihood of future vaccine acceptance for them and their families.

Examples for a comfortable vaccination

There are a number of ways to make vaccine injections more comfortable for adults (PDF). Combining strategies can help reduce pain during vaccination.

Some examples include:

• Answer questions individuals have about vaccination and reassure them that having questions is normal and welcome;
• Select the appropriate needle length and gauge to minimize pain;
• If giving multiple separate injections, start with the vaccine that causes the least amount of pain or discomfort;
• Position the individual upright during vaccination, unless they prefer to lie down. This makes the client an active participant rather than passive where something is being ‘done to them’;
• Suggest patients press their legs together (muscle tension technique) or lie down if they feel dizzy;
• Encourage relaxation of the arm before injection;
• Encourage use of coping techniques based on individual preferences. Some examples include deep breathing and distraction; and
• Avoid aspiration and inject vaccines quickly.

Muscle tension technique

If a patient feels dizzy or faint during an injection, have them squeeze the muscles in their legs and stomach. Ask them to keep squeezing for 10-15 seconds until their face feels warm. Relax for 20-30 seconds and then ask them to repeat a few times or until the symptoms go away. Alternatively, they can lie down during the procedure.

Needle fear

If a patient has a high level of needle fear, consider referral to a mental health expert, such as a psychologist. Treating needle fear can help alleviate the stress that is sometimes associated with needles. Overcoming needle fear will increase comfort and help patients to be more accepting of future vaccinations and other needle procedures.

Additional resources

• Canadian Immunization Guide - Techniques to decrease immunization injection pain
• CANVAX - Health worker training module: managing pain during vaccine administration
• Immunize Canada - Immunization Pain Management - clinician focus
  (Note: the CARD system can be used for adults)
• BC Centre for Disease Control - Communicable Disease Control Manual/Chapter 2: Immunization Appendix D - Reducing Immunization Injection Pain
• Clinical Practice Guideline on management of vaccination pain (from birth to adulthood) – Canadian Medical Association Journal
• World Health Organization - Reducing pain at the time of vaccination: WHO position paper
• World Health Organization - Meeting of the Strategic Advisory Group of Experts on immunization: conclusions and recommendations reducing pain and distress at the time of vaccination (p. 269-271)